Prevalence of rheumatic heart disease in school children of urban Lahore.
OBJECTIVE
To determine the prevalence of rheumatic heart disease (RHD) among school children in urban and semiurban areas of Lahore, Pakistan.


METHODS
A cross-sectional survey of school children aged 5-15 years from 70 schools of urban and semiurban Lahore was carried out by a team of cardiologists. Children were screened by clinical examination and diagnosis confirmed by echocardiography. Sociodemographic data were also collected.


RESULTS
Of 24 980 children screened, 986 (3.9%) had a confirmed cardiac lesion; 546 had RHD, 440 had congenital heart disease. The prevalence of RHD was 21.9/1000 children screened (95% CI 20.1 to 23.7). Their mean (SD) age was 10.7 (2.6) years and the female:male ratio was 1.6:1. Most (92.5%) were unaware of the diagnosis and less than 2% were taking rheumatic prophylaxis. All children belonged to a low socioeconomic group and 67% were undernourished.


CONCLUSIONS
The prevalence of RHD in the urban school population of Lahore is among the highest in the world. The younger age of onset is a special feature and most are unaware of the diagnosis, and hence not receiving life-saving secondary prophylaxis.
Sadiq
M
M
Department of Paediatric Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan. drmasoodsadiq@hotmail.com
Islam
K
K
Abid
R
R
Latif
F
F
Rehman
A U
AU
Waheed
A
A
Azhar
M
M
Khan
J S
JS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000453:epidemiology; D008946:Mitral Valve Stenosis / Q000453:epidemiology; D020380:Needs Assessment; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012214:Rheumatic Heart Disease / Q000453:epidemiology*; D012574:Schools; D014504:Urban Health